Sample Record for 2019-09-30-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213702 DEA: 041G4304 EFIS: 0412000126
QA Service Level: 1
DIST-CO-RTE-PM: 04-NAP-128-R7.4
Work Description: REPLACE BRIDGE, HMA PAVING, DRAINAGE AND RSP
Location Description: NAPA COUNTY NEAR SAINT HELENA AT CONN CREEK
Contractor Name: GHILOTTI CONSTRUCTION CO. INC.
Contractor Address: 246 GHILOTTI AVENUE, SANTA ROSA, CA 95407
Resident Engineer: Paramdeep Brar Structure Rep.: Nana Budu
Sample Information
DIME Sample ID: 2019-09-30-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Control
Type of Material: SMTL TM5 - Welded Hoops
Sample Taken Date: 09/30/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/01/2019
The quantity of what the sample constitutes: 3 lots with a total 314 pcs
A brief description of the sample: #6 X 2'-7" Dia Hoops
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar
Material Information
Production or Authorization Testing: Production Testing
Service or Ultimate: Service
Rebar Heat Number(s): 4089775
Hoop Manufacturer Lot Number(s): Lot 1-3
Material Standard Code: ASTM A706
Material Grade: 60
Rebar Size: 6
Diameter of Hoop: 2'-7"
Epoxy Coated: No
Epoxy Coating Color: NA
Rebar Manufacturer: cmc steel Arizona
Welding Company: CMC Rebar (Etiwanda)
Coating Standards: Uncoated
Weld Type: Flash Welded
Test Results
